Physician Compare National (NPI:1609990993)

HEALTHCARE PROVIDER: LEE ROY LISKEY MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1609990993
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3577456052
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040206000862
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LISKEY
	Individual professional last name
Provider First Name	LEE
	Individual professional first name
Provider Middle Name	ROY
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2480 MISSION ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 108
	Group Practice or individual's line 2 address
City	SAN FRANCISCO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	941102479
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4156422000
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050008
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CALIFORNIA PACIFIC MEDICAL CTR-DAVIES CAMPUS HOSP
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050047
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CALIFORNIA PACIFIC MEDICAL CTR-PACIFIC CAMPUS HOSP
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	050055
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	CALIFORNIA PACIFIC MEDICAL CTR - ST. LUKE'S CAMPUS
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y